If you ask my children what I do, they usually say I’m an oncologist – a cancer specialist. It’s true that I work for Texas Oncology and spend many of my days with cancer patients. But there’s another important side of our specialty and practice – a side that impacts millions of Americans every year. Patients with blood disorders are treated by hematologists, and many oncologists are also board-certified in hematology. So even though you don’t have cancer, you may be treated by a physician who specializes in both cancer and blood disorders.
Blood disorders affect one of the main components of blood – red blood cells, white blood cells, and platelets. Treating these disorders is a key focus for me as a hematologist. Some of the most common blood conditions to be treated by a hematologist are anemia, sickle cell disease, and thrombosis.
UNDERSTANDING THE COMPONENTS OF BLOOD
Blood is living tissue made up of liquid and solids. The liquid part is called plasma. The solid part contains red blood cells, white blood cells, and platelets. Blood cells constantly die and the body makes new ones. Red blood cells live about 120 days, platelets six days, and white cells less than one day.
• Plasma: Plasma is made of water, salts, and proteins. More than half of your blood is plasma.
• Red Blood Cells: Red blood cells deliver oxygen from your lungs to your tissues and organs.
• White Blood Cells: White blood cells fight infection and are part of your body’s defense system.
• Platelets: Platelets help blood to clot.
• Bone Morrow: Bone marrow, the spongy material inside your bones, makes new blood cells.
BREAKING DOWN THE DIFFERENT BLOOD DISORDERS
Anemia affects more than 3 million Americans. It’s a condition that results from a shortage of red blood cells, either because the body does not make enough red blood cells, doesn’t replace lost red blood cells fast enough, or actively destroys red blood cells. A protein in red blood cells called “hemoglobin” is needed to carry oxygen to the lungs and to carry carbon dioxide out of the lungs. Often, anemia is caused by a deficiency in iron, vitamin B-12 or folate, but it can also be caused by chronic diseases, including cancer. Hematologists treat anemia by treating its cause – treatment could be as minimal as changes in diet and vitamin supplements or could involve blood transfusions or a bone marrow transplant.
Hemophilia is a rare, typically inherited blood disorder where the blood does not properly clot. Patients may suffer from internal bleeding, which can cause damage to organs, joints, and tissues. Symptoms can range from mild to severe. While there is no cure, there are several advanced treatment techniques which can significantly improve a patient’s quality of life.
Sickle cell disease is the most common inherited red blood cell disorder. Sick cell disease affects approximately 100,000 American with varying severity. People with sickle cell disease inherit a gene mutation from both parents that changes the shape of hemoglobin in red blood cells. This distorts the shape of the red blood cells themselves, from a round, flexible, donut-like shape to a slender, rigid, crescent moon or “sickle” shape. The abnormal shape and stiffness makes red blood cells more likely to slow blood flow, block blood vessels and cut off circulation, especially in small blood vessels. This can cause pain and organ damage over time. Patients with sickle cell disease also have a high risk of blockage of larger blood vessels leading to stroke. While sickle cell disease is a serious, lifelong condition, treatments have vastly improved in the last 40 years, enabling people to live with the disease for decades. Hematologists can manage sickle cell disease with preventative treatments and interventions when complications occur, and are working to develop a permanent cure
Thrombosis affects about 900,000 Americans with up to 100,000 deaths each year, according to the Centers for Disease Control and Prevention. There are several types of thrombosis, all related to blood clots in various parts of the body, which can be very serious and even fatal if the clot travels to the lungs. While cancer can be a risk factor, many people with thrombosis develop the condition from factors completely unrelated to cancer, including being sedentary for long periods of time (such as an all-day flight), recent surgery, age, family history, certain medications, alcohol consumption, current or recent pregnancy, smoking, and obesity. Hematologists can treat thrombosis with blood thinner medications or special compression socks.
RECOGNIZING PATIENTS IN THE FIGHT AGAINST BLOOD DISORDERS
Blood disorders may not have widelyrecognized awareness months or speciallycolored ribbons, but my patients with these conditions are every bit as heroic, fighting against their disease. They deserve all the support and encouragement we can give them. To learn more about hematology, visit www.texasoncology.com/services-andtreatments/medical-programs/hematology.
Dr. Balesh Sharma is a hematologist and medical oncologist at Texas Oncology– Brownsville, 2150 N. Expressway 83 in Brownsville, Texas, 956-548-0810. To learn more, visit www.TexasOncology.com.